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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1385132



Case Details

VAERS ID: 1385132 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-31
Onset:2021-06-04
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 UN / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, COVID-19, Mechanical ventilation, Pneumonia
SMQs:, Interstitial lung disease (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: case hospitalized due to COVID. Case in the ICU with pneumonia and ARDS and currently on a ventilator.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1385132


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